Laserfiche WebLink
,r <br />-Application <br />- FOR - <br />Certificate icate o f Appropriateness <br />Historic Preservation Commission of South Bend & St. Joseph County <br />125 S. Lafayette Blvd., South Bend, Indiana 46601 <br />Mailing Address: County City Building, South Bend, Indiana 96601 <br />Phone: 574235-9798 • Fax: 574235-9578 . Email• SBSJCHPC@cost joseph.in.us <br />Website: httfr//,Kwwstjosephcountyindiana.com/sichp/index.bttnl. . <br />OFFICE USE ONLY »»» DO NOT COMPLETE ANY ENTRIES CONED IN THIS BOX--- OFFICE USE ONLY <br />Date Received' / � 1546#- aZ0/1 Application Number ed0_/ I - 4.s(/e7- <br />Past Reviews: �L' J (Date Of IBS+ tZIT 1GIC) <br />Staff Approval authorized by: <br />❑ NO <br />Title: . <br />Historic Commission Review Date: <br />i <br />cal Landmark Local Historic District (Name) <br />National Landmark National Register District (Name) <br />Certificate of Appropriateness: <br />E] Denied F] Tabled ❑ Sent To Committee [] Approved and Issued <br />DATE <br />Address of Property for proposed work: <br />+ Street Number and Street Marne <br />Name of Property Owner(s): (Pimse Print),1L __ <br />Address of Property Owner(s): �•3llr�-,%t!n/1 PE,4 �O <br />Contractor(s) Name: iBl> t t et AA-vRAr-rz.r--- <br />Contract Company Name: v/ �o • . <br />Contractor Address: 1-7 _ , <br />City, Phone: Z - <br />Current Use of Building r7/Nl�.L�s►mr� <br />(Single Farm7y - Mniti-Family - Cormrrercial - 0xvnnneni - I,rdustrial - Vacant - etc.) <br />Type of Building Construction: iW60,0 A4 Frtr� D <br />(Wood Frame - Brick - Stone - Steel - Concrete - Other) <br />Proposed Work: ❑ In-kind E] Landscape [�'lvew E] Replacement (not in-kind) ❑ Demolition <br />(naon than one lvx nmy tr cherW) <br />Description of Proposed Work: i 11-6 5K- t h11 e46 �twd Mau A -0 -a -A ' U s t r4& <br />E1F i571rJ� 8 tic. it.+u��wl hS f"ota N+'�-Ttart . 12 �►°[ A�� ley �►h 8:7-A FkA-wa. <br />4i—au e_raa=E. W{tr(4- FLAr ?-P At P P -v aF IAALD% CA4a-mt nmr-WIP4L ow!r, <br />Ts3 J�to/Z �>sOEif,¢��tr<OJtf. <br />Owner/Contractor: Fax: -7 — Zf9r 5'L'f e-mail % � aPe.,-14 <br />(77d, gTxc tvi11 rnrrrsjwrd r n1y case ,Ime) r <br />and/or __-- <br />— APPLICATION REQUIREMENTS ARE LISTED ON REVERSE SIDE — <br />